Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Clinical Comp > Depressive Disorders > Flashcards

Depressive Disorders Flashcards

1
Q

In disruptive mood dysregulation disorder, the mood between temper outbursts is what?

A

Irritable or angry.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

In disruptive mood dysregulation disorder symptoms must be present for how long?

A

12 or more months.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

In disruptive mood dysregulation disorder symptoms must be present for 12 or more months but the individual cannot go how many consecutive months without symptomology?

A

Three.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How many settings must the criteria for disruptive mood dysregulation disorder be met in?

A

At least two of three settings (at home, school, with peers)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the age of onset for disruptive mood dysregulation disorder?

A

Prior to age 10.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What disorders can’t disruptive mood dysregulation disorder coexist with?

A

Oppositional defiant disorder, intermittent explosive disorder or, or bipolar disorder.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Why isn’t disruptive mood dysregulation disorder included with bipolar related disorders?

A

Bipolar disorder is explicitly reserved for episodic presentations.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the age requirements for disruptive mood dysregulation disorder?

A

Must be before age ten but not less than a developmental age of six.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

True or false. Rates of conversion from disruptive mood dysregulation disorder to bipolar disorders is high.

A

False.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How can bipolar be differentiated from disruptive mood dysregulation disorder?

A

Bipolar disorders manifest as episodic with discrete periods of mood perturbation. A child cannot be diagnosed with a mood dysregulation disorder if they have had a manic or hypomanic episode lasting more than 1 day

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

True or false. Someone with can have a manic or hypomanic episode and be diagnosed with disruptive mood dysregulation disorder?

A

False.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are differential diagnoses of disruptive mood dysregulation disorder and ADHD, MDD, anxiety disorders, and ASD

A

ADHD, MDD, and/or anxiety can be comorbid diagnoses

MDD/Depressive disorders: irritability present in only the context of a depressive episode or dysthymia should receive one of those diagnoses, not disruptive mood dysregulation disorder

ASD: Children with ASD may present with temper outbursts when routines are disturbed and in these cases they should not be diagnosed with a disruptive mood dysregulation disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How can disruptive mood dysregulation disorder be differentiated from intermittent explosive disorder?

A

Intermittent explosive disorder does not require persistent disruption in mood between episodes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How long must symptoms be present for in major depressive disorder?

A

Two weeks.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the criteria for an MDD diagnosis

A

A: Five or more of the following symptoms have been present during the same two-week period and represent a change from previous functioning. At least one of the symptoms is 1) depressed mood or 2) loss of interest or pleasure

“SIGECAPS+Depressed mood”

  • Sleep (insomnia or hypersomnia)
  • Interest or pleasure loss
  • Guilt or worthlessness feelings
  • Energy loss
  • Concentration diminishes
  • Appetite
  • Psychomotor retardation or agitation
  • Suicidal ideation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

MDD Specifiers: Severity

A

Mild:

  • few, if any symptoms, in excess to make a diagnosis
  • Intensity is distressing but manageable and result in minor impairment in social or occupational functioning

Moderate:

  • # of symptoms, intensity, and/or functional impairment are between those in “mild” and “severe”

Severe:

  • # of symptoms in excess required
  • intensity is seriously distressing and unmanageable
  • symptoms markedly interfere with social and occupational functioning
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

MDD Specifiers: With psychotic features: delusions and/or hallucinations are present

A
  • with mood-congruent psychotic features:
    • content of all delusions/hallucinations is consistent with the depressive themes of inadequacy, guilt, disease, death, or deserved punishment
  • with mood-incongruent psychotic features
    • content of delusions/hallucinations does not involve typical depressive themes, or the content is a mixture of mood-congruent and incongruent themes.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

MDD Specifiers: Remission

A
  • In partial remission
    • symptoms of the immediate episode are present but do not meet full criteria, OR there is a period lasting less than 2 months without significant symptoms of an episode following the end of one
  • In full remission
    • No signs/symptoms in the past 2 months
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Depressive Disorder Specifiers: With Anxious Distress

A

Anxious distress includes the presence of at least two of the following during the majority of days of an MDD/dysthymic episode:

  • Feeling keyed up or tense
  • Feeling unusually restless
  • Difficulty concentrating due to worry
  • Fear that something awful may happen
  • Feeling that the person may lose control of self

Severity:

  • Mild = 2
  • Moderate = 3
  • Moderate-severe = 4-5
  • Severe = 4-5 w/ motor agitation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Depressive Disorder Specifiers: with mixed features

A

At least 3 of the following manic/hypomanic symptoms are present nearly every day during the majority of the episode:

  • elevated, expansive mood
  • inflated self-esteem or grandiosity
  • more talkative than usual or pressure to keep talking
  • flight of ideas or experience that thoughts are racing
  • increased energy or goal-directed activity
  • increased or excessive involvement in activities that have a high potential for painful consequences
  • Decreased need for sleep

Represent a change from usual behavior and are observed by others

Do not meet full criteria for a manic/hypomanic episode

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Depressive Disorder Specifiers: with melancholic features

A

1 of the following is present during the most severe period of the current episode

  • Loss of pleasure in all, or almost all, activities
  • Lack of reactivity to usually pleasant stimuli

3 or more of the following:

  • A distinct quality of depressed mood characterized by profound despondency, despair, and/or moroseness or by so-called empty mood
  • Depression worse in the AM
  • Early-morning awakening
  • Marked psychomotor agitation or retardation
  • Significant anorexia or weight loss
  • Excessive or inappropriate guilt
22
Q

Depressive Disorder Specifiers: with atypical features

A

When the following features predominate during the majority of the current/most recent episode

  • Mood reactivity (mood brightens in response to actual or potential positive events)
    • Capacity to be cheered up when presented with positive events
    • Mood may become euthymic even for extended periods of time if external circumstances remain favorable
  • 2 or more of the following
    • Significant weight gain or increase in appetite
    • Hypersomnia
      • Total of at least 10 hours per day
    • Leaden paralysis (heavy feelings in arms or legs)
    • A long-standing pattern of interpersonal rejection sensitivity that results in sig social or occupational impairment
      • Occurs when a person is not depressed, though it may be exacerbated during depressive periods
23
Q

Depressive Disorder Specifiers: with catatonia

A

Catatonia features are present during most of the episode

  • a marked decrease in reactivity to the environment
    • Resistance to instructions (negativism)
    • Maintaining a rigid, inappropriate, or bizarre posture
    • Complete lack of verbal and motor responses
  • Can include purposeless and excessive motor activity without an obvious cause
  • Repeated stereotype movements, staring, grimacing, mutism and echoing of speech
24
Q

Depressive Disorder Specifiers: with peripartum onset

A

Can be applied to the current or most recent episode if onset occurs during pregnancy or in the 4 weeks following delivery

  • mood episodes can have their onset either during pregnancy or postpartum
  • Women often experience severe anxiety and even panic attacks
  • Mood and anxiety symptoms during pregnancy increase the risk for a postpartum episode
  • Peripartum-onset mood episodes can present either with or without psychotic features
25
Q

Depressive Disorder Specifiers: with seasonal patterns

A
  • Temporal relationship between onset of the episode(s) and time of the year
  • Full remissions also occur at a characteristic time of the year
  • In the last 2 years, two episodes have occurred that demonstrate the temporal relationship defined above and no nonseasonal episodes have occurred
  • Seasonal episodes substantially outnumber nonseasonal episodes during the person’s lifetime
26
Q

Why is MDD different than grief?

A

Grief is predominantly feelings of emptiness and loss as opposed to depressed mood and inability to anticipate happiness/pleasure

Sadness from grief decreases with time and comes in waves usually tied to thoughts

Grief may come with positive emotions and humor uncharacteristic of an episode of major depression

Thought content in grief is associated with the deceased and is not self-critical or generally pessimistic

Self-esteem is generally preserved in grief

Thoughts about death and dying in grief are usually about the deceased

27
Q

What differentiates major depressive disorder from a mood disorder due to another medical condition?

A

MDD can be diagnosed if it is determined that the mood disorder is not due to the consequences of a specific medical condition (e.g., multiple sclerosis, stroke, hypothyroidism)

28
Q

ADHD vs MDD

A

Distractibility and low frustration tolerance occur in both

If criteria for both are met, then both can be diagnosed

Be careful of overdiagnosing MDD in children as presentation of mood disturbance in ADHD is characterized by irritability rather than sadness/loss of interest

29
Q

Adjustment Disorder with depressed mood vs MDD

A

MDD that occurs in response to a psychosocial stressor is distinguished in that full criteria are met for MDD. otherwise, adjustment disorder with depressed mood would be diagnosed.

30
Q

True or false. Any individual with major depressive disorders can never have a manic or hypomanic episode?

A

True.

31
Q

Persistent Depressive Disorder (Dysthymia)

A

Depressed mood for most of the day, for more days than not for 2 years

Presence, while depressed, of two (or more) of the following

  • poor appetite or overeating
  • insomnia or hypersonmnia
  • low energy or fatigue
  • low self-esteem
  • poor concentration or difficulty making decisions
  • feelings of hopelessness

2 year period where the individual has never been without symptoms for more than 2 months

MDD may be continuously present for 2 years

No manic or hypomanic episode

32
Q

What age is the threshold between early onset and late onset in Persistent Depressive Disorder?

A

21

33
Q

PDD Specifiers: most recent 2 year period of PDD has what three specifiers?

A
  • with pure dysthymic syndrome*: where full criteria for a major depressive episode have not been met in at least the last 2 years
  • with persistent major depressive episode*: where full criteria for an MDE have been met throughout the past 2 years
  • with intermittent major depressive episodes, with current episode*: where full criteria for an MDE is currently met, BUT there have been periods of at lease 8 weeks where symptoms were below the threshold for an MDE
  • with intermittent major depressive episodes, without current episode*: full criteria for a MDE are not currently met, BUT there has been one or more MDE in the preceding 2 years.
34
Q

PDD Differential Diagnoses (MDD, psychotic disorders, depressive or bipolar disorder due to another med condition, and personality disorder)

A
  • MDD: the 2 year duration of PDD distinguishes it from episodes of depression in MDD that do not last 2 years
  • Psychotic disorders: Depressive symptoms are common in chronic psychotic disorders, a separate diagnosis of PDD is not made if these occur only during the course of the psychotic disorder
  • Depressive/bipolar disorders due to another med condition: This is self-explanatory. If the depressive disorder is caused by a medical condition, then it is distinguished from PDD
  • Personality disorder: If someone meets criteria for both, then both diagnoses are given
35
Q

How long must individuals have symptoms to qualify for a Persistent depressive disorder (dysthymia) diagnosis?

A

Two years.

36
Q

During the two years of Persistent depressive disorder (dysthymia) a person has never been how many months with symptoms?

A

Two months.

37
Q

How can Persistent depressive disorder (dysthymia) be differentiated from major depressive disorder?

A

Major depressive episodes do not last for two years.

38
Q

Premenstrual Dysphoric Disorder Criteria

A
  1. In the majority of menstrual cycles at least 5 symptoms are present in the final week before the onset of menses, start to improve within a few days after the onset of sense, and become minimal or absent in the week post menses
  2. One (or more) must be present
    • Marked affective lability (mood swings)
    • Marked irritability or anger or increased interpersonal conflicts
    • Marked depressive mood, feelings of hopelessness, or self-deprecating thoughts
    • Marked anxiety tension, and/or feelings of being keyed up or on edge
  3. One or more of the following must additionally be present to reach the total of 5 symptoms when combined with criterion B
    • Decreased interest in usual activities
    • Subjective difficulty in concentration
    • Lethargy, easy fatigability, or marked lack of energy
    • Marked change in appetite (overeating or specific food cravings)
    • Hypersomnia and insomnia
    • Sense of being overwhelmed or out of control
    • physical symptoms like breast tenderness/swelling, joint or muscle pain, sensation of “bloating” or weight gain
  4. A-C must have been met for most menstrual cycles within the past year
  5. Symptoms are clinically distressing
  6. Disturbance is not an exacerbation of another disorder (MDD, panic disorder, PDD)
39
Q

All together how many symptoms must be present in premenstrual Dysphoria disorder?

A

Five or more.

40
Q

How is premenstrual Dysphoria disorder confirmed?

A

Prospective daily ratings.

41
Q

Premenstrual Dysphoric Disorder Differential Diagnoses

Premenstrual syndrome

Dysmenorrhea

Bipolar Disorder, MDD, or PDD

Hormone Treatments

A

Premenstrual Syndrome: In PMS a minimum of 5 symptoms are not required with no prerequisite of affective symptoms

Dysmenorrhea: (painful periods) begin with onset of menses rather than Premenstrual Dysphoric Disorder that beings before onset.

Bipolar, MDD, PDD: Symptoms from these disorders do not follow a premenstrual pattern

Hormones: If symptoms occur once hormones are used then it may be due to hormone use rather than underlying disorder.

42
Q

Substance/Medication-Induced Depressive Disorder Criteria

A
  1. Prominant and persistent disturbance in mood characterized by depressed mood or markedly diminished pleasure in all, or almost all, activities
  2. Hx of evidence of both:
    1. symptoms in Criterion A developed during/soon after intoxication or withdrawal or after exposure to a med
    2. the involved substance/med is capable of producing symptoms in Criterion A
  3. Disturbance is not better explained by a depressive disorder where:
    1. The symptoms precede the onset of med use
    2. Symptoms persist for substantial time after withdrawal or intoxication.
    3. Other evidence suggesting the existence of an independent non-substance induced disorder
  4. Does not occur during course of a delirium
  5. Disturbance causes clinically significant distress
43
Q

Substance/Medication-Induced Depressive Disorder Onset Specifiers

A
  • With onset during intoxication*: criteria are met for intoxication and the symptoms develop during intoxication
  • With onset during withdrawal*: if criteria are met for withdrawal from the substance and the symptoms develop during/shortly after withdrawal.
44
Q

Substance/Medication Induced Depressive Disorder Differentials

Substance Intoxication/Withdrawal

Primary Depressive Disorder

Depressive Disorder due to Another Medical Condition

A
  • Substance intoxication/withdrawal
    • Diagnosis of substance-induced depressive disorder should be made if mood symptoms are sufficiently severe to warrant independent clinical attention and are substantially more intense or longer-lasting than what is usually encountered with withdrawal.
  • Primary Depressive Disorder
    • Substances are judged to be related to symptoms
  • Depressive Disorder due to Another Medical Condition
    • Mood symptoms are caused by the consequences of the medical condition rather than medication. BOTH diagnoses can be made if it is determined that the disturbance is a function of both
45
Q

Depressive Disorder Due to Another Medical Condition Criteria

A
  1. Prominant & persistent period of depressed mood/diminished pleasure in all or almost all activities
  2. Evidence from hx and such that the disturbance is the consequence of a med condition
  3. Disturbance is not better explained by another mental disorder
  4. Disturbance does not occur during delirium
  5. Disturbance causes clinically significant distress
46
Q

Depressive Disorder Due to Another Medical Condition Specifiers

A
  • With depressive features*: full criteria for an MDE no met
  • With major depressive-like episode*: full criteria (except Criterion C) met for MDE
  • With mixed features:* symptoms of mania or hypomania are also present but do not predominate the clinical picture
47
Q

Depressive Disorder Due to Another Medical Condition Differential Dxs

A
  • Depressive disorders not due to another medical condition
    • Determine whether the cause is from a medical condition or not. Dependent on symptoms onset
  • Medication-induced depressive disorder
    • Use clinical judgment to separate what is most likely and most important of the two etiological factors.
  • Adjustment disorders
    • Major differentiating elements are the pervasiveness of the depressive picture and the number of symptoms reported
48
Q

Other Specified Depressive Disorder Criteria

A
  1. Symptoms are characteristic of a depressive disorder but do not meet full criteria
  2. Chosen when the clinician chooses to communicate the reason that the presentation doesn’t meet full criteria
  3. Examples of presentations are:
    • Recurrent brief depression
      • Concurrent presence of depressed mood and at least 4 other symptoms for 2-13 days at least once a month for at least 12 months but has never met criteria for any other disorder
    • Short-duration depressive episode (4-13 days)
      • Depressed affect and at least 4 of the 8 symptoms of an MDE that persists for more than 4 days, but less than 14.
    • Depressive episode with insufficient symptoms:
      • Depressed affect and at least 1 of the other 8 symptoms of an MDE for at least 2 weeks.
49
Q

Unspecified Depressive Disorder Criteria

A
  • Presentations in which symptoms characteristic of a depressive disorder cause sig distress but do not meet full criteria for any of the disorders in the diagnostic class
  • Used in situations in which the clinician chooses NOT to specify the reason that criteria are not met for the specific depressive disorders
50
Q
A
51
Q
A

Clinical Comp (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions